Implementing an Antepartum Epilepsy Monitoring Unit


Poster Presentation

Purpose for the program

The purpose of the epilepsy monitoring unit is to provide a safe environment for pregnant women on teratogenic antiepileptic drugs (AEDs) and research the maternal–fetal effects while doing so. In the United States, three to five of 1,000 births are from women who have a form of epilepsy. Many of these women take class D AEDs during their pregnancies. When clinically advantageous, women who take class D AEDs are converted in a controlled environment to an AED with less adverse fetal effects.

Proposed Change

Research indicates that AED drug conversion is done best in a monitored environment. Continuous fetal monitoring provides invaluable clinical information on fetal status while the AED drug conversion is taking place.

Implementation, Outcomes, and Evaluation

The clinical team has established a multidisciplinary group consisting of neurology, maternal–fetal medicine, nursing, and administrative leadership to build the physical environment; identify training needs; and form policies, procedures, and best practices. The epilepsy monitoring unit is newly developed and ongoing evaluation is taking place.

Implications for Nursing Practice

Knowledge for the clinical team has been broadened to include epilepsy in pregnancy, seizure management, and adverse effects of AEDs. Successful outcomes have already been achieved in a safe environment, which provides a model for other healthcare facilities.